Böbrek Hücreli Karsinomlu Hastaların Demografik Özellikleri ve Tedavi Sonuçları: Tek Merkez Deneyimi

Objectives: The aim of the study was to evaluate demographic characteristics and treatment outcomes of patients with renal cell cancer.  Materials and Methods: Data of 100 patients diagnosed with RCC at Ataturk Research and Education Hospital between the years 2005-2014 are analyzed retrospectively. Kaplan-Meier test were performed for survival analysis.  Results: Median age of patients was 62 (25-89) and 40% of the population was over 65 years old. Sex ration (male/female)  was 2/1. Radical nephrectomy was perfomed 64 % of patients also partial nephrectomy rate was 7%.  Histopathologically, clear cell varient’s rate was 84 %. Most of the patients were stage 4 (55%)  and the most common metastatic site was lung (34%). After the development of metastases, first line interferone (IFN) treatment was administered to 62 of patients and 49 of these took tirosine kinase inhibitor after IFN treatment. For all patients, median follow-up time was 24 months and median overall survival (OS) was 36 months. We determined that OS was 30 months and progression free survival (PFS) was 15 months among patients had recieved sunitinib. During sunitinib treatment, dose reduction was performed in 53.8% of the patients and treatment was interrupted in 36.6% of the patients. Fatigue (34.9%) and anemia (27.9%) were the most common grade 3-4 toxicities. In patients who used sunitinib, median PFS in the good, intermediate and poor risk patients according to Memorial Sloan Kettering Cancer Center (MSKCC) criteria respectively were 45, 15 and 6 months (p=0.05). In multivariate analysis, we found that age over 65 years  (p=0.04),  grade 3-4 tumors (p=0.05) and the poor risk according to MSKCC criteria (p=0,04) are associated with decreased overall survival. Conclusion: The majority of our patients were male, younger than 65 years and had advanced disease at diagnosis. The significantly improvement in survival has been observed between the nephrectomized and metastatic RCC patients who used sunitinib at our clinic.